Middle Eastern Journal of Disability Studies

fa مقایسهٔ اثربخشی متادون‌درمانی با درمان ترکیبی شناختی‌رفتاری همراه با متادون بر عقاید وسوسه‌انگیز و اضطراب نوجوانان دارای سوء‌مصرف مواد Comparing the Effectiveness of Methadone Therapy and Combination of Cognitive-Behavior Therapy Along with Methadone Therapy Alone on Anxiety and Craving Beliefs in Adolescents Addicted with Substance Abuse روانشناسی Psychology مقاله پژوهشی اصیل Original Research Article چکیده زمینه و هدف: اعتیاد به مواد مخدر به‌عنوان یکی از چالش‌های بزرگ در جوامع بشری، ابعاد و زوایای پیدا و پنهان بسیاری دارد؛ به‌همین دلیل این مسئله از جنبه‌های مختلفی قابل تأمل و بررسی است. پژوهش حاضر با هدف مقایسهٔ تأثیر متادون‌درمانی با درمان ترکیبی شناختی‌رفتاری همراه با متادون بر عقاید وسوسه‌انگیز و اضطراب نوجوانان دارای سوء‌مصرف مواد انجام شد. روش‌بررسی: پژوهش حاضر از نوع نیمه‌آزمایشی با طرح پیش‌آزمون پس‌آزمون بود. جامعهٔ آماری این پژوهش را تمامی افراد گروه تحت درمان با متادون تشکیل دادند که در زمستان ۱۳۹۶ به مراکز ترک اعتیاد شهر اصفهان مراجعه کردند. از بین آنان تعداد ۳۰ نفر به‌صورت نمونه‌گیری دردسترس انتخاب شده و به‌طور تصادفی در دو گروه قرار گرفتند. یکی از گروه‌‌ها علاوه‌بر متادون درمان شناختی‌رفتاری را نیز دریافت کرد. ابزار گردآوری داده‌ها شامل آزمون اضطراب بک و آزمون عقاید وسوسه‌انگیز بود. داده‌ها در دو سطح توصیفی (میانگین و انحراف معیار) و استنباطی (کولموگروف‌اسمیرنف، تحلیل کوواریانس) و با استفاده از نرم‌افزار SPSS نسخهٔ ۲۱ در سطح ۹۵درصد اطمینان تحلیل شدند. یافته‌ها: یافته‌های این پژوهش نشان داد که بین تأثیر درمان شناختی‌رفتاری به‌همراه درمان نگهدارندهٔ متادون و متادون‌درمانی به‌تنهایی بر اضطراب (۰٫۰۴۳=p) و عقاید وسوسه‌انگیز (۰٫۰۰۱>p) نوجوانان معتاد دارای سوءمصرف مواد تفاوت وجود دارد. نتیجه‌گیری: یافته‌های این پژوهش حاکی‌از اثربخشی بیشتر درمان ترکیبی شناختی‌رفتاری همراه با متادون درمقایسه با متادون‌درمانی به‌تنهایی بر اضطراب و عقاید وسوسه‌انگیز نوجوانان معتاد است؛ بنابراین استفاده از این درمان ترکیبی به متخصصان در این زمینه توصیه می‌شود. Abstract Background & Purpose: Drug abuse refers to the use of narcotics in a manner that is harmful to the drug consumer himself/herself or others, which is a form of substance–related disorder. Different definitions of drug abuse are used in public health, medicine, and justice and criminal justice. In some cases, when a person is affected by drugs, he or she faces offensive or antisocial behavior, and a long–term personality change may occur. In addition to physical, social, and psychological harm, the use of some substances may lead to criminal penalties, although this depends on the local judicial rules. In 2013, substance use disorders caused the deaths of 127000 people, compared with 1990, which was 51000. Drug disorders caused the death of 4300 people, amphetamine disorders caused 3800 deaths, and alcohol–related disorders caused 139000 deaths. The purpose of this study was to compare the effectiveness of the combination of cognitive–behavior therapy and methadone therapy with methadone therapy alone on the anxiety and craving beliefs in adolescents with substance abuse. Methods: This quasi–experimental study employed a pretest–posttest design. The statistical population of the study consisted of all opioid–addicted patients living in Isfahan City (Isfahan Province, center of Iran) who were referred to addiction treatment centers in Isfahan during the winter of 2017. The sample was selected as available. In this regard, 30 male addicts who were referred to the addiction treatment center for opioid withdrawal and treatment were selected. Subjects were randomly divided into experimental and control groups containing 15 subjects. One group received methadone therapy, and the other group received methadone therapy and cognitive–behavior therapy. The data were collected using the Beck Anxiety Inventory and the Craving Beliefs Inventory by Right and Beck. The Beck Anxiety Inventory is a self–report inventory that is used for measuring the severity of anxiety in children and adults. The questions used in this measure ask about common symptoms of anxiety that the subject has had during the past week, including the testing day (such as numbness and tingling, sweating not due to heat, and fear of the worst happening). It is designed for individuals 17 or older and takes 5 to 10 minutes to complete. Several studies have found the Beck Anxiety Inventory to be an accurate measure of anxiety symptoms in children and adults. This inventory contains 21 questions, each answer being scored on a scale value of 0 (not at all) to 3 (severely). Higher total scores indicate more severe anxiety symptoms. The standardized cutoffs are as follows: 0–9, normal to minimal anxiety; 10–18, mild to moderate anxiety; 19–29, moderate to severe anxiety; and 30–63, severe anxiety. Although drug craving has been defined in numerous ways, it has generally been regarded as a desire to use a drug. Craving is usually considered a subjective experience because one must be aware of a desire to crave. With few exceptions, craving has been conceptualized as reflecting a drug–acquisitive state, which motivates drug use. Despite the popular appeal of craving as a construct, several definitional issues remain unresolved. To analyze the data, the mean and standard deviation were calculated at the descriptive level, and at the inferential level, covariance analysis and the Kolmogorov–Smirnov test were performed using SPSS 21. Results: The difference between the two groups was significant in anxiety (p=0.043) and craving beliefs (p<0.01), indicating that a combination of cognitive–behavior therapy and methadone therapy was more effective than methadone therapy alone. Conclusion: Combination methadone therapy with cognitive–behavior therapy is an effective method for the treatment of drug abuse consequences and is recommended to all professionals in this field. درمان شناختی‌رفتاری, درمان نگهدارندهٔ متادون, عقاید وسوسه‌انگیز, اضطراب Cognitive–Behavioral Therapy, Methadone maintenance treatment, Substance abuse, Anxiety, Craving beliefs 129 129 http://jdisabilstud.org/browse.php?a_code=A-10-974-3&slc_lang=fa&sid=1 Behnaz Abooie بهناز ابویی behnazabooie1367@gmail.com 100319475328460064524 100319475328460064524 Yes MA Student in Psychology, Yazd Islamic Azad University, Yazd, Iran کارشناسی‌ارشد روان‌شناسی، دانشگاه آزاد اسلامی یزد، یزد، ایران Mohsen Saeidmanesh محسن سعیدمنش M.SAEIDMANESH@yahoo.com 100319475328460064525 100319475328460064525 No Associate Professor, Department of Psychology, Yazd Science and Arts University, Yazd, Iran دانشیار گروه روان‌شناسی دانشگاه علم و هنر یزد، یزد، ایران Tayebe Mardani طبیه مردانی TAYEBEMARDANI1367@GMAIL.COM 100319475328460064526 100319475328460064526 No MA Student in Clinical Child Psychology, Yazd Science and Arts University, Yazd, Iran دانشجوی کارشناسی‌ارشد بالینی کودک‌ونوجوان دانشگاه علم و هنر یزد، یزد، ایران